Intraoperative Neurophysiological Monitoring During Spinal Cord Tumor Surgery.

Intramedullary spinal cord tumor surgery has evolved through major technological advances. From early attempts in the 19th century to modern methods, innovations like the operative microscope, bipolar coagulation, and MRI have transformed practice. The introduction in the 1980s of intraoperative neurophysiological monitoring enabled real-time spinal cord functions assessment through the application of monitoring techniques. In this article, we will review the state of the art of the different techniques, the alarm criteria and related recovery strategies, current controversies and future considerations.